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Archived: Jane Lewis Health and Social care

The provider of this service changed - see old profile

This service is now registered at a different address - see new profile

Reports


Inspection carried out on 1 August 2013

During a routine inspection

We spoke with people who received support from the agency to gain their views on how well the agency were providing safe and appropriate care. People told us that a manager had been to visit them before the service commenced to discuss their needs and they had agreed a plan of care. They said that care workers came at the agreed times and rang if they were going to be late due to unforeseen circumstances. One person told us that his care worker was very flexible and fitted in with him if he wanted to change the time of the visit to accommodate social events.

People said their support needs were being met and that they had confidence in the staff who were visiting them. Comments included: " I get on great with my care worker, I've no complaints whatsoever"; "Everything's fine, they're very good"; "It's an excellent service and I can't fault them"; "They're very, very good and I'm more than satisfied".

Two of the people we case tracked were having their medication administered by care workers. Both said this was working well and records showed that it was given as prescribed.

The service had effective recruitment and selection procedures in place.

There were also effective systems in place to assess and monitor the quality of service and identify and manage any risks.

Inspection carried out on 5 March 2013

During an inspection to make sure that the improvements required had been made

We inspected this service in August 2012 and found that the registered provider was non-compliant in three areas.

We carried out this inspection to see what progress the registered provider had made in achieving compliance.

We found that the service had improved and only one area needed further work.

We spoke with people who received support from the agency to gain their views on how well the agency were providing safe and appropriate care. People said their support needs were being met and that they had confidence in the staff who were visiting them. Comments from the people we contacted by telephone included: "The staff are very pleasant and helpful and the care is absolutely terrific"; "On the whole the staff are very nice and the care is good"; "I'm very lucky to get this care and support".

The service had systems in place to assess and monitor the quality of service and identify and manage any risks.

The only area that required further improvement was the communication between the office and people who used the service about who would be visiting and the timing of visits when the person's regular care worker was on leave.

Inspection carried out on 16 August 2012

During a themed inspection looking at Domiciliary Care Services

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they could make choices about their care. The inspection team was led by a CQC inspector and joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We carried out fifteen telephone interviews and four home visits to people who used the service and to their main care givers (a relative or friends) to gain views about the service. We spoke with three of the care staff members, a team leader, the domiciliary care manager and the registered manager during the inspection.

We are aware that due to changes in contracting arrangements with the local council the agency has recently taken on a new contract and the number of people now supported by them increased earlier this year. This has meant that new staff members have had to be appointed. The changes have led to problems with missed and late calls and the lack of consistency with staffing for some of the people using the service. We have spoken to the registered manager who explained that they were trying to address the issues we have identified in this report as soon as possible and were working with the people using the service and the local council in order to do so.

Most of the people who spoke to us said that they had been able to say what they wanted, or had been asked whether or not they agreed with the package at the beginning of the service. However, some people said staffing issues, for example, late calls and different carers arriving could limit the choices available and impacted on their ability to receive individualised care.

Comments from the people we visited or contacted by telephone included a mixture of both positive and negative opinions.

“I understand the choices we have and that we can say what we would like to happen, but am also realistic.” “I couldn’t rely on the times, they were supposed to come and give me tea at 5.30pm but sometimes it was 7.30pm and I was ready for bed; that’s no good to me.” “I can say if I want something done a bit different and stuff like that.” “I can ring and tell them what I want but it doesn’t make much difference, the times are still all over the place.”

The people who spoke to us who were more positive about the service tended to have been receiving care from a particular worker for some time. They said they could tell the carers how they liked things done and that their wishes would be respected. Comments included; “They do involve mum in decisions and she always does as much as she can for herself”, “The girls usually respond well if I ask for anything, or for something to be done a particular way”, “They don’t talk to me like I’m a child and they accept I might have an opinion.” On the other hand negative comments were received from people who said that their care was not being provided consistently; “The chopping and changing of hours and people is a real issue. I’m never sure who is coming. The girls may all be very nice but I feel more consistency would be so much better, I spend so much time explaining things.” “I would like to know who is coming, maybe not the same girl every time but several who come regularly. But I have all sorts coming. I don’t seem to have much choice about that.”

We spoke with people who received support from the agency to gain their views on how well the care staff members were providing safe and appropriate care. People with regular carers said their support needs were being met and that they had confidence in the staff members who were visiting them. Comments from the people we visited or contacted by telephone included, “Very good, all round nice person.” “Absolutely lovely.” “My regular girl is excellent.” “One girl always says, if you can [wash yourself], do; it keeps you well.” Those who did not have a regular carer or if there were problems with late or missed visits were more negative. Their comments included; “Some just come in without calling, they are busy into everything and I don’t even know they are there”, “No shows can be an issue; they don’t always let you know either.” “Telling the office things doesn’t seem to make much difference.” “I can ring the office and tell them, I do if the girls don’t come or if they are late but they just seem to fob you off or tell you any old thing.”

People told us that an assessment of their needs had been carried out when they started receiving support from the agency. This had then been used by the staff and with the person to produce a care plan and risk assessments for them to work to. Everyone we spoke with said they had a care folder with all the details of their assessments and plans. One person told us that they did help to decide on their care plan and was happy with what they were receiving. Another person said, “I and my (family member) were involved at the start.”

We asked people whether they were asked about the quality of care being provided. Comments included; “I was told to let them know if anything was not to my liking and I do”, “Girls are lovely”, “Carers always ask how I want things to be done.” On the other hand some of the comments we received were negative. These included; “The girls may all be very nice but I feel more consistency would be so much better, I spend so much time explaining things”, “There can be huge differences in the times they get here. I know there is traffic but it might be one and a half to two hours difference from one day to the next. They are supposed to serve my dinner, I can’t plan when to put it in the oven, or when to have my medication.”

Whilst people had not received any specific information about reporting abuse they confirmed that they would attempt to contact the office if they had any concerns about the service or the support they received. Comments included, “I would report anything like that”, “I would report it, not leave it to just go on maybe getting worse.”

People with regular carers said their support needs were being met and that they had confidence in the staff members who were visiting them. Comments included, “I feel at ease.”

The people we spoke to gave differing views about the understanding and knowledge of the workers they received care from. Those who were most positive tended to have been receiving care from a particular worker for some time. Comments included; “Always treats me with respect, doesn’t rush me”, “I am always asked how I want things to be done”, “Some seem to have a natural sort of understanding.” The people who did not have regular carers and often did not know who was visiting them told us that timekeeping was a real problem and that some of the staff supporting them did not have enough skills or knowledge to do the job properly.

Some of the people we spoke with said they had experienced problems trying to get the office to rectify problems in service delivery and address concerns. Comments included; “I was telling her [senior staff member] facts about